History Of Allergic Symptoms Research Articles

Oral Immunotherapy in Patients with IgE Mediated Reactions to Egg White: A Clinical Trial Study

ABSTRACT Background Oral immunotherapy (OIT) is under consideration as a promising treatment for desensitization of egg-allergic patients. The objective of this study was to assess the effectiveness of egg-white OIT in patients with IgE-mediated allergy to egg white and to compare the clinical and laboratory findings before and after OIT. Methods This clinical trial was performed from February to August 2018 in Rasool e Akram Hospital, Tehran, Iran. Patients’ selection criteria included a history of allergic symptoms, skin prick test (SPT) reactivity to egg white, and the inability to pass the Oral Food Challenge (OFC). Egg-white OIT was done for eight patients in the OIT group for 6 months while egg-white-free products were administrated for controls. The SPT reactivity, specific IgE, and IgG4 for egg white and ovomucoid were evaluated before and after OIT. Results Hundred percent of the subjects in OIT group were desensitized and tolerated 40 cc raw egg white following 6-month maintenance whereas none of the controls was able to pass the OFC. The findings obtained from the evaluations indicated a significant decrease in the wheal size and specific IgE to egg white after OIT (P = .001). Furthermore, a significant decrease of IgE/IgG4 ratio to egg white was found in OIT group (P = .01). Conclusion This OIT protocol was successful as all OIT patients were able to continue 6-month OIT process and the reaction threshold to egg white increased in the OIT group. Therefore, it could be regarded as an effective and safe protocol to treat egg-allergic patients.

Food allergy, airborne allergies, and allergic sensitisation among adolescents living in two disparate socioeconomic regions in Ecuador: A cross-sectional study

BackgroundAllergic diseases are under-investigated and overlooked health conditions in developing countries. We measured the prevalence of food allergy (FA), airborne allergic disease, and allergic sensitisation among adolescents living in 2 socio-demographically disparate regions in Ecuador. We investigated which risk factors are associated with these conditions. MethodsA cross-sectional study involved 1338 students (mean age: 13 ± 0.9 years old) living in Cuenca (n = 876) and Santa Isabel (n = 462). History of allergic symptoms (noted by parents or doctor) to food, house dust mites (HDM), pollen, and pets were recorded. Sociodemographic characteristics, environmental exposures, and parental history of allergic disorders data were collected. Sensitisation to 19 food and 20 aeroallergens was measured by skin-prick testing (SPT). FA and airborne allergic diseases (to HDM, pollen, cat, or dog) were defined as a report of allergic symptoms noted by doctor, together with a positive SPT (wheal size ≥3 mm). Logistic regression models were used to identify environmental and parental factors associated with allergic conditions. ResultsFA was prevalent among 0.4% (95% CI 0.2%–0.9%), and food sensitisation among 19.1% of the adolescents. Shrimp was the most frequent food linked with FA and food sensitisation. Risk factors associated with FA could not be evaluated due to the low prevalence. Food sensitisation was higher among adolescents exposed to family smoking (OR 1.63, 95% CI 1.14–2.34, p = 0.008) and those with parental history of allergic disorders (OR 1.68, 95% CI 1.13–2.49, p = 0.01), but less common among adolescents owning dogs (OR 0.59, 95% CI 0.41–0.84, p = 0.003).Airborne allergic diseases were prevalent amongst 12.0% of the adolescents (95% CI: 10.4–13.9, n = 1321), with HDM as the primary allergen (11.2%). Airborne allergic diseases were less common among adolescents with more siblings (OR 0.79, 95% CI 0.65–0.96, p = 0.02) and those who lived with farm animals in the first year of life (OR 0.47, 95% CI 0.23–0.95, p = 0.04), but, most common among adolescents with a smoking family (OR 1.67, 95% CI 1.04–2.70, p = 0.03) and with a parental history of allergic disorders (OR self-perceived: 2.62, 95% CI 1.46–4.71, p = 0.001; OR diagnosed by a doctor: 4.07, 95% CI 2.44–6.80, p < 0.001). ConclusionsFA and airborne allergies are less prevalent in Ecuador than in developed regions; there is a great dissociation between the prevalence of allergic disease and allergic sensitisation. Shrimp and HDM were the most prevalent allergens. Risk factors identified in this study to be related to allergic diseases should be considered by physicians, health practitioners, and epidemiologists in Ecuador.

Effects of high temperature on existing allergic symptoms and the effect modification of allergic history on health outcomes during hot days among adults: An exploratory cross-sectional telephone survey study

ObjectiveThe effects of high temperature on existing allergic conditions are unclear. This study explored the prevalence of allergic symptoms and the effects of high temperature on existing allergic symptoms among an adult population. The effects of high temperature on other non-allergic health outcomes were compared between adults with and without a history of allergic symptoms. MethodA cross-sectional telephone survey study was conducted in Hong Kong two weeks after a heat wave in 2017. Socio-demographic information, history of allergic symptoms, non-allergic health symptoms and self-reported changes of allergic symptoms during the study hot period were collected using multiple-choice questions. ResultsOf the 436 respondents, 24% had reported an allergic history. During the study hot period, 22.4% and 15.7% of those who had skin and nasal allergies had reported worsen symptoms comparing to normal days. Comparing to people without an allergic history, those ever having allergic symptoms reported a higher rate of mucus secretions, mouth ulcers, poorer sleeping quality and worsen mood during the study hot period. The main limitation of this study is the lack of baseline information and the changes in symptoms were based on self-report basis. ConclusionA noticeable proportion of the study adult population reported an allergic history. Some of these symptoms got worse during period of high temperature. Pre-existing allergic symptoms were found associated with more adverse health effects and worse quality of life during hot days. Strategic health promotion policy should be planned to increase the awareness of the potential impacts of high temperature on allergy and the related health issues.

Neonatal vitamin A supplementation associated with increased atopy in girls.

Neonatal vitamin A supplementation (NVAS) is currently being considered as policy in countries at risk of deficiency. A previous study suggested that NVAS may be associated with increased atopy. We examined the effect of NVAS on atopy by conducting long-term follow-up of a previous randomized controlled trial in Guinea-Bissau. In 2002-2004, we randomized 4345 normal birthweight neonates to NVAS (50000IU retinyl palmitate) or placebo together with their Bacillus Calmette-Guérin vaccination. In 2013, we visited the 1692 (39%) children now aged 8-10years who were still living in the study area, and 1478 (87%) were found at home. Provided consent, a skin prick test was performed, and history of allergic symptoms was recorded. Associations of NVAS and atopy (defined as skin prick test reaction of ≥3mm) were analysed using binomial regression. Of the 1430 children with a valid skin prick test, 228 (16%) were positive (more boys (20%) than girls (12%), P-value<0.0001). NVAS did not increase the overall risk of atopy (RR 1.10 [95% CI 0.87-1.40]). However, NVAS was associated with significantly increased risk among females (RR 1.78 [1.17-2.72]) but not among males (0.86 [0.64-1.15], P-value for interaction between NVAS and gender=0.005). Furthermore, NVAS was associated with increased risk of wheezing among females (RR 1.80 [1.03-3.17], but not among males, P-value for interaction=0.05). The study corroborated previous observations; NVAS was associated with increased risk of atopy and wheezing, in this study only among females. Further studies on NVAS and atopy are warranted.

Joint effects between five identified risk variants, allergy, and autoimmune conditions on glioma risk

Common variants in two of the five genetic regions recently identified from genome-wide association studies (GWAS) of risk of glioma were reported to interact with a history of allergic symptoms. In a pooled analysis of five epidemiologic studies, we evaluated the association between the five GWAS implicated gene variants and allergies and autoimmune conditions (AIC) on glioma risk (851 adult glioma cases and 3,977 controls). We further evaluated the joint effects between allergies and AIC and these gene variants on glioma risk. Risk estimates were calculated as odds ratios (OR) and 95 % confidence intervals (95 % CI), adjusted for age, gender, and study. Joint effects were evaluated by conducting stratified analyses whereby the risk associations (OR and 95 % CI) with the allergy or autoimmune conditions for glioma were evaluated by the presence or absence of the 'at-risk' variant, and estimated p interaction by fitting models with the main effects of allergy or autoimmune conditions and genotype and an interaction (product) term between them. Four of the five SNPs previously reported by others were statistically significantly associated with increased risk of glioma in our study (rs2736100, rs4295627, rs4977756, and rs6010620); rs498872 was not associated with glioma in our study. Reporting any allergies or AIC was associated with reduced risks of glioma (allergy: adjusted OR = 0.71, 95 % CI 0.55-0.91; AIC: adjusted OR = 0.65, 95 % CI 0.47-0.90). We did not observe differential association between allergic or autoimmune conditions and glioma by genotype, and there were no statistically significant p interactions. Stratified analysis by glioma grade (low and high grade) did not suggest risk differences by disease grade. Our results do not provide evidence that allergies or AIC modulate the association between the four GWAS-identified SNPs examined and risk of glioma.

Epidemiology of allergic rhinitis in Korean children

Purpose: The diagnosis of allergic rhinitis (AR) is based upon the concordance between a history of allergic symptoms and diagnostic tests. This study is to investigate the epidemiology of AR by using data from National Health Insurance Corporation (NHIC) and data according to the AR definition in general students health screening. Methods: We examined medical insurance claims data of NHIC from 2004 to 2010 according to age, area, and gender. We investigated the results of Korean International Study of Asthma and Allergies in Childhood questionnaires and skin prick tests of 14,133 students participated in health screening from 2010 to 2012. Results: The prevalence of AR according to the NHIC data was elementary school students (24.34%); middle school students (13.75%) and high school students (12.17%). The prevalence of AR was higher in boy than in girl, annually. In health screening, the prevalence of AR was elementary school students (19.50%±0.26); middle school students (23.19%±0.30) and high school students (24.11%±0.31). The prevalence of AR had peaking at the age late teens (P<0.0001) and was higher in boy (26.49%±0.38) than in girl (17.43%±0.35) (P<0.0001). Sensitization rate of allergen in students with AR was house dust mite (86.71%±0.48); pollen (41.26%±1.01) and molds (14.80%±0.52). Conclusion: The prevalence according to the AR definition tended to be increased with aging in Korean children. There are some differences in the prevalence of AR in the data of NHIC and health screening study. Further investigation will be needed to reveal the causes of this difference.

Diagnostic tests for human allergic disease

The diagnosis of human allergic disease begins with a thorough clinical history and physical examination. Once a temporal relationship has been identified between a patient's history of allergic symptoms and a defined allergen exposure, confirmatory analyses for IgE antibody involving skin or blood testing are performed to verify sensitization. Debate continues over the relative diagnostic utility of the in vivo and in vitro measures of IgE antibody. This overview examines the strengths and limitations of primary diagnostic confirmatory methods for in vivo detection (skin test, provocation test) and in vitro quantification of IgE antibody. A literature review was performed to examine diagnostic performance characteristics and variables that influence the accuracy of IgE antibody assays. The clinical history and both in vivo and in vitro measures of IgE antibody are subject to variability and potential patient, clinician and technician-related bias. As such, in the absence of an absolute clinical history-based gold standard for defining the presence of allergic disease, the relative diagnostic performance (sensitivity, specificity) of in vivo versus in vitro assays of IgE antibody cannot be effectively determined. The review examines which allergic disease states and allergen specificities allow both groups of IgE antibody assays to produce comparable qualitative data for assessing the state of allergic sensitization. Skin testing has experienced few recent technological innovations, whereas an explosion has occurred in the improved performance (analytical sensitivity and specificity) of in vitro assays and enhanced quality of reagents for IgE antibody quantification. This review discusses the impact of point of care-testing assays, microarrays, the use of native and recombinant allergen molecules, automation, and disease prediction algorithms and the 2008 Clinical and Laboratory Standards Institute Guideline on IgE antibody methods, on the diagnosis of human allergic disease.

Prevalence of allergic symptoms among children with diabetes mellitus type 1 of different socioeconomic status

The aim of the study was to assess the possible associations between allergies and type 1 diabetes mellitus (DM1), stratified by social class. We studied 127 children with DM1 with a median age of 10.8 yr and 150 controls of comparable age and sex distribution. The parents completed questionnaires on their education and occupation and on their children's history of allergic symptoms, breast-feeding, viral infections, and measles-mumps-rubella (MMR) vaccination. Lower family's social class was more frequently encountered among the DM1 families than in the controls (OR = 0.56, 95% CI: 0.35-0.92). The occurrence of any allergic symptoms among children with DM1 (35.45%) was not significantly different from the controls (38.78%), neither in the total group (OR = 0.87, 95% CI: 0.52-1.45) nor in the stratified analysis by social class. Similar findings were observed regarding the different types of allergic symptoms. In the univariate analysis, breast-feeding, the experience of viral infections, and MMR vaccination were found to be protective of DM1 presentation in both upper and lower social classes. In the multiple logistic regression analysis, the experience of more than 2 infections/yr (OR = 0.12, 95% CI: 0.04-0.34), the origin from middle and upper social classes (OR = 0.42, 95% CI: 0.22-0.80) and breast-feeding (OR = 0.58, 95% CI: 0.31-1.07) were protective of DM1 occurrence. In children with DM1, the presence of allergic symptoms was not associated with the development of DM1. Among the environmental factors, the origin from middle or upper social classes, breast-feeding, the experience of viral infections, and MMR vaccination were found to have a protective effect on DM1 presentation.

Is there a need for special preventive medical check-ups in employees exposed to experimental animal dust?

Due to new legal requirements in Germany, the employer must request preventive medical check-ups for activities involving exposure to dust from experimental animals in the rooms in which the animals are kept. The objective is to report our first experiences with these medical check-ups in the context of academic research. The check-ups were carried out since November 2005 and comprised a questionnaire and a medical examination, including a pulmonary function test with whole-body plethysmography. Respiratory, nasal and ocular symptoms related to occupational exposure to animals were documented. Participation in skin prick tests (ubiquitous inhalation allergens and laboratory animal allergens), a bronchial provocation test with methacholine, and serological examinations for total IgE and specific IgE antibodies was voluntary. Data on 132 persons are presented. One hundred and six of these had already been exposed for at least 1 year. Main complaints at the workplace were sneezing and runny nose. Ocular symptoms and bronchial asthma were reported infrequently. The development of at least one of these symptoms occurred in 34% of employees with an exposure of at least 1 year. If the weekly exposure duration was at least 5 h, the proportion of employees with complaints rose to 44.9%. In employees occupationally exposed to mice and rats, work-related complaints occurred in 33.7 and 37.8%, respectively, and sensitisation rates were 12.7 and 16.3%, respectively. Employees with and without complaints differed in history of allergic symptoms, and workplace safety measures. In employees with occupational contact with laboratory animal dust, the frequency of complaints was high. The results confirm the necessity of regular medical check-ups for employees with contact with laboratory animal dust. Nevertheless, the medical check-ups must be part of a prevention strategy including education, engineering controls, administrative controls, use of personal protective equipment and vocational integration.

Traffic, Susceptibility, and Childhood Asthma

Results from studies of traffic and childhood asthma have been inconsistent, but there has been little systematic evaluation of susceptible subgroups. In this study, we examined the relationship of local traffic-related exposure and asthma and wheeze in southern California school children (5–7 years of age). Lifetime history of doctor-diagnosed asthma and prevalent asthma and wheeze were evaluated by questionnaire. Parental history of asthma and child’s history of allergic symptoms, sex, and early-life exposure (residence at the same home since 2 years of age) were examined as susceptibility factors. Residential exposure was assessed by proximity to a major road and by modeling exposure to local traffic-related pollutants. Residence within 75 m of a major road was associated with an increased risk of lifetime asthma [odds ratio (OR) = 1.29; 95% confidence interval (CI), 1.01–1.86], prevalent asthma (OR = 1.50; 95% CI, 1.16–1.95), and wheeze (OR = 1.40; 95% CI, 1.09–1.78). Susceptibility increased in long-term residents with no parental history of asthma for lifetime asthma (OR = 1.85; 95% CI, 1.11–3.09), prevalent asthma (OR = 2.46; 95% CI, 0.48–4.09), and recent wheeze (OR = 2.74; 95% CI, 1.71–4.39). The higher risk of asthma near a major road decreased to background rates at 150–200 m from the road. In children with a parental history of asthma and in children moving to the residence after 2 years of age, there was no increased risk associated with exposure. Effect of residential proximity to roadways was also larger in girls. A similar pattern of effects was observed with traffic-modeled exposure. These results indicate that residence near a major road is associated with asthma. The reason for larger effects in those with no parental history of asthma merits further investigation.

Prostaglandin E2 Induces MUC8 Gene Expression via a Mechanism Involving ERK MAPK/RSK1/cAMP Response Element Binding Protein Activation in Human Airway Epithelial Cells

MUC8 gene expression is overexpressed in nasal polyp epithelium and is also increased by treatment with inflammatory mediators in nasal epithelial cells. These data suggest that MUC8 may be one of important mucin genes expressed in human airway. However, the mechanisms of various inflammatory mediator-induced MUC8 gene expression in normal nasal epithelial cells remain unclear. We examined the mechanism by which prostaglandin E(2) (PGE2), an arachidonic acid metabolite, increases MUC8 gene expression levels. Here, we show that ERK mitogen-activated protein kinase is essential for PGE2-induced MUC8 gene expression in normal human nasal epithelial cells and that p90 ribosomal S 6 protein kinase 1 (RSK1) mediates the PGE2-induced phosphorylation of cAMP-response element binding protein. Our results also indicate that cAMP-response element at the -803 region of the MUC8 promoter is an important site of PGE2-induced MUC8 gene expression. In conclusion, this study gives insights into the molecular mechanism of PGE2-induced MUC8 gene expression in human airway epithelial cells.

Coexistence of IgE-Mediated Allergy and Type 1 Diabetes in Childhood

Background: Autoimmune disorders are considered to be associated with a Th1 immune response while allergic diseases with a Th2 response. We carried out a study to determine whether there is an inverse relationship between allergic diseases in IgE-sensitized children or positive skin-prick test reactions to allergens and type 1 diabetes mellitus (DM1) in children. Methods: Sixty-three children with DM1 and 108 controls were enrolled. Parents of all children compiled a questionnaire on allergic diseases. All children underwent skin-prick tests for common aero-allergens and food-allergens. Results: A history of allergic symptoms, especially wheezing, asthma and allergic rhinitis was significantly less common in the group with DM1. Allergic symptoms in children with IgE sensitization or parental atopy were no more likely in children with DM1 than in normal control subjects. There was no association between skin-prick test results to inhalants and food allergens and DM1. Conclusions: Consistently with the Th1/Th2 paradigm, we observed a reduction in the frequency of allergic symptoms in children with DM1. However, our study did not succeed in demonstrating an inverse relation between Th1- and Th2-mediated diseases in children with IgE sensitization or an atopic genetic predisposition.

Standardization of food allergen extracts for skin prick test

The aim of the study was to standardize and evaluate technically optimized food allergen extracts for use in skin prick test (SPT). The standardization procedure comprised 36 allergic histories in 32 food allergic patients with 21 healthy, non-atopic individuals serving as controls. The patients had a history of allergic symptoms upon ingestion of either cow’s milk ( n=3), hen’s egg ( n=9), wheat ( n=4), hazelnut ( n=14) or cod ( n=6). They also had specific IgE in serum to the food in question and a positive SPT with a fresh preparation of the food. The diagnosis had been confirmed by a double-blind, placebo-controlled food challenge, except for the hazelnut-allergic patients. The controls were subjected to an open food challenge with all the foods to ensure tolerance. The standardization was performed by means of titrated SPT in accordance with the guidelines on biological standardization from the Nordic Council on Medicine. Regression analysis of the skin wheal areas was performed for each patient and the median protein concentration of allergen preparation (median C h10) eliciting a wheal area of the same size as histamine 10 mg/ml was calculated. The median C h10 was 0.56 mg/ml for milk, 0.88 mg/ml for egg, 5.4 mg/ml for wheat, 2.1 mg/ml for hazelnut and 0.017 mg/ml for the cod extract. The sensitivity of the median C h10 estimated from the SPT data was 1 for milk, 0.98 for egg, 1 for wheat, 1 for hazelnut and 0.87 for the cod extract. The allergenic activity of the hazelnut extract was further investigated by leukocyte histamine release (HR) and immunoblotting experiments using sera from 27 hazelnut allergic patients. The clinical sensitivity of the optimized hazelnut extract evaluated by HR was 0.78 compared to 0.30 for a commercially available hazelnut extract (Soluprick). Immunoblotting results showed a stronger IgE binding capacity and additional IgE-binding bands of the optimized hazelnut extract compared with the Soluprick extract.

A Placebo-Controlled Trial of a HEPA Air Cleaner in the Treatmentof Cat Allergy

1. Wood RA, 2. Johnson EF, 3. Van Natta ML, 4. Hua Chen P, Eggleston PA (1998) Am J Respir Crit Care Med. 158:115–120. [OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] #### Purpose of the Study Air cleaners and air filtration devices have enjoyed considerable popularity as a form of environmental control to remedy allergic problems. There are, however, many unanswered questions in regard to their efficacy. This study attempts to address the question of efficacy of the high-efficiency particulate arrestor (HEPA) cleaners in reducing allergen levels and disease activity in the homes of cat-allergic patients who continue to live with the triggering allergen (cat). ##### Study Population This study involved adults who had asthma and/or allergic rhinitis. They all had a history of allergic symptoms with cat exposure to the extent they required daily medications. They also had at least one cat in the home. ##### Methods A 1-month baseline period helped to determine the minimum amount of medication needed to control asthma and/or allergic rhinitis symptoms. Daily … [1]: {openurl}?query=rft.jtitle%253DAmerican%2BJournal%2Bof%2BRespiratory%2Band%2BCritical%2BCare%2BMedicine%26rft.stitle%253DAm.%2BJ.%2BRespir.%2BCrit.%2BCare%2BMed.%26rft.issn%253D1073-449X%26rft.aulast%253DWOOD%26rft.auinit1%253DR.%25A0A.%26rft.volume%253D158%26rft.issue%253D1%26rft.spage%253D115%26rft.epage%253D120%26rft.atitle%253DA%2BPlacebo-controlled%2BTrial%2Bof%2Ba%2BHEPA%2BAir%2BCleaner%2Bin%2Bthe%2BTreatment%2Bof%2BCat%2BAllergy%26rft_id%253Dinfo%253Adoi%252F10.1164%252Fajrccm.158.1.9712110%26rft_id%253Dinfo%253Apmid%252F9655716%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1164/ajrccm.158.1.9712110&link_type=DOI [3]: /lookup/external-ref?access_num=9655716&link_type=MED&atom=%2Fpediatrics%2F104%2FSupplement_2%2F380.3.atom [4]: /lookup/external-ref?access_num=000074730700019&link_type=ISI

A Placebo-Controlled Trial of a HEPA Air Cleaner in the Treatmentof Cat Allergy

Wood RA, Johnson EF, Van Natta MLHua Chen P, Eggleston PAAm J Respir Crit Care Med.1581998115120Air cleaners and air filtration devices have enjoyed considerable popularity as a form of environmental control to remedy allergic problems. There are, however, many unanswered questions in regard to their efficacy. This study attempts to address the question of efficacy of the high-efficiency particulate arrestor (HEPA) cleaners in reducing allergen levels and disease activity in the homes of cat-allergic patients who continue to live with the triggering allergen (cat).This study involved adults who had asthma and/or allergic rhinitis. They all had a history of allergic symptoms with cat exposure to the extent they required daily medications. They also had at least one cat in the home.A 1-month baseline period helped to determine the minimum amount of medication needed to control asthma and/or allergic rhinitis symptoms. Daily diaries were kept regarding medication use, peak flow, nasal and chest symptom scores, and sleep difficulty. At a home visit, the number of cats and the presence of carpeting was noted. Baseline air and dust samples were collected in the patient's bedroom. Pillows and mattresses were then covered and bedding was washed weekly. Patients were instructed to keep the cat(s) out of the bedroom. A second home visit was conducted to ensure compliance with the environmental control measures. For the next 3 months, a Honeywell Environcare HEPA filter was placed in the bedroom. This unit provided 15 air changes/hour in a 12- × 15-foot room. In the control group the filter was removed. Home visits occurred every month to sample the air and dust. A timer on the air filter units monitored compliance. Cat antigen, Fel d 1, was measured by enzyme-linked immunosorbent assay (ELISA). Other variables that were evaluated included spirometry, methacholine sensitivity, and radioallergosorbent test (RAST).There were 35 patients in the study; 17 served as the control group. All study patients had cat-induced rhinitis and 28 had cat-induced asthma. Thirteen study patients had one cat and 18 had two. All but 1 patient had carpeting in the bedroom. There were no significant differences between the treatment and control groups in medication use or demographics. There was no change in the level of airborne Fel d 1 in either group during the baseline period when the cat was kept out of the bedroom and covers were in place. When the HEPA filter was added, there was a modest decrease over 3 months in the level of airborne Fel d 1 in the group with the active air filter. The geometric mean level decreased from 3.0 ng/m3 at baseline to 1.7 ng/m3 at 3 months. There was no difference in cat allergen levels in settled dust samples at any point during the study. There was a trend toward decreased nighttime nasal symptoms in the treatment group; however, this did not reach statistical significance. No significant differences were observed in chest symptoms, peak flow measures, sleep, medication use, spirometry, methacholine challenges, or RAST results.The HEPA filter did provide for a significant decrease in Fel d 1 levels in the air. However, those using a HEPA filter did not experience any significant difference in any measure of disease activity for both rhinitis and asthma.It must be noted that this paper does not deal with children at all; however, it does deal with a common problem that affects children. Parents see these forms of allergy treatment advertised and may ask their pediatricians about their efficacy. There are numerous options available for environmental control, many of which have not been studied in any rigorous way. This article points out a number of key concepts using this form of environmental control measure. Airborne levels do decrease, but the new level achieved was not associated with significant differences in disease control. The study emphasizes the importance of avoidance and the lack of efficacy of the HEPA units in this model of allergy.

Soluble cytokine receptor CD30 in atopic disorders: a case-control study.

The cytokine receptor CD30 is an activation marker of T cells which preferentially associates with the production of the TH2 cytokine IL-4. Therefore, it may potentially be a candidate marker for atopic disorders and a target molecule for new therapeutic approaches. To test the hypothesis that elevated levels of soluble CD30 (sCD30) are significantly associated with atopic disorders after adjustment for other predictors of atopy. The presence of elevated sCD30 (> or = 20 U/mL) in atopic disorders was evaluated in a nested case-control study. Cases (n = 60) were blood donors with specific IgE antibodies, total serum levels of IgE > or = 100kU/L and presence or history of allergic symptoms. Controls (n = 59) were blood donors without presence or history of allergic symptoms and serum levels of IgE < 50 kU/L. sCD30 was determined from serum samples by an enzyme-linked immunosorbent assay. Odds ratios (OR) and confidence intervals (CI) were calculated from logistic regression coefficients. Mean sCD30 levels for cases were 75 U/mL (SD 110U/mL) as compared with 35 U/mL (SD 59 U/mL) for controls. Serum levels of sCD30 were elevated in 65% of cases and 32% of controls (OR 3.9, 95% CI 1.8-8.4). The odds ratio for elevated sCD30 as a predictor of atopic disorders slightly decreased to 3.7 after controlling for smoking, age and gender. Blood eosinophilia which was a strong predictor of atopy (OR 11.7) was a weak confounder of the association between sCD30 levels and atopic disorders. Family history of allergy, another strong predictor of atopy (OR 8.6), did not confound the association. The results are consistent with the hypothesis that CD30 is involved in the pathogenesis of atopic disorders independent of eosinophilia and family history of allergy.

Airway responsiveness to sulfur dioxide of healthy subjects with history of allergic symptoms

Airway responsiveness to sulfur dioxide of healthy subjects with history of allergic symptoms

The pattern of food hypersensitivity in patients with onset after 10 years of age.

One hundred and twelve patients with a history of immediate adverse reaction after food ingestion and positive skin test to food are presented with the result of food challenge. In all patients the symptoms started after 10 years of age; most presented with recurrent short-lasting urticarial rash, often accompanied by rhinitis. In the majority of the patients, skin tests were positive to multiple food allergens, but 67% of these responded to oral provocation by only one allergen. One-third of the patients had a history of allergic symptoms following exercise after meals, but in only one-third of these symptoms were reproducible in the laboratory. Fruit and vegetables were the main allergens responsible for food hypersensitivity. Food allergy can develop after the first 10 years of life. Fruit and vegetables are the main cause of food allergy in these patients, while milk and egg are the least common. These findings differ from those in early childhood where milk and eggs are the main allergens.

818 Correlation between history of allergic symptoms and type I sensitization in children

818 Correlation between history of allergic symptoms and type I sensitization in children

A subtle organic component in some cases of mental illness. A preliminary report of cases.

A syndrome is described which is found in individuals who have a family history of allergic symptoms and who also have a family history of a carbohydrate-related metabolic disease. It is characterized by certain mental symptoms which appear in part to be due to the effect of unknown intermediate metabolites of certain foods—producing a subtle organic component—and often is accompanied by physical symptoms which may simulate allergy. The characteristic mental state is one consisting of motor hyperactivity, affective lability and intensity, and certain cognitive defects, with corresponding ego-control defects. There is a vulnerability to sudden regressive shifts in all functions, probably physiologically determined.